关节镜下免打结锚钉结合双束高强缝线重建前交叉韧带胫骨止点撕脱骨折

Arthroscopic Reconstruction of ACL Tibial Avulsion Fracture with Knot Free Anchor and Double Bundle High-Strength Suture

目的:探讨关节镜下Pushlock免打结锚钉结合双束高强缝线重建前交叉韧带(ACL)胫骨止点撕脱骨折的临床疗效。方法:收集2015年1月至2023年1月接受手术治疗的前交叉韧带胫骨止点撕脱骨折患者100例临床资料,所有患者均接受关节镜下Pushlock免打结锚钉结合双束高强缝线的手术治疗,术前及末次随访时,对全部患者采用Lachman试验和前抽屉试验进行体格检查,同时检查是否存在膝前痛或局部压痛;采用Lysholm膝关节评分量表、国际膝关节评分委员会(IKDC)膝关节评分表、Tegner膝关节运动水平评分系统评价患膝功能恢复水平,采用膝关节屈伸活动范围(ROM)评价膝关节的稳定性和活动度。结果:100例前交叉韧带胫骨止点撕脱骨折患者均顺利完成手术,末次随访时Lachman试验和前抽屉试验均为阴性,Lysholm评分、IKDC评分、Tegner评分均显著高于术前,差异有统计学意义(P<0.01);膝关节活动度较术前显著提高,差异有统计学意义(P<0.01);X线片显示100例患者骨折均达解剖复位或近解剖复位并骨性愈合。结论:关节镜下Pushlock免打结锚钉结合双束高强缝线重建前交叉韧带胫骨止点撕脱骨折手术疗效明确,结果满意,值得推广应用。

Objective:To explore the clinical efficacy of arthroscopic reconstruction of anterior cruciate ligament(ACL)tibial avulsion fractures with Pushlock anchors and dual bundle high-strength sutures.Methods:Clinical data of 100 patients with ACL tibial insertion avulsion fractures who underwent surgical treatment from January 2015 to January 2023 were collected.All patients underwent arthroscopic surgery using Pushlock anchors combined with dual bundle high-strength sutures.Prior to surgery and at the final follow-up,all patients underwent physical examination using the Lachman test and anterior drawer test,while also checking for presence of anterior knee pain or local tenderness.The Lysholm knee joint scoring scale,the International Knee Joint Scoring Committee(IKDC)knee joint scoring scale,and the Tegner knee joint motion level scoring system were used to evaluate the functional recovery level of the affected knee.The range of motion(ROM)of knee joint flexion and extension was used to evaluate the stability and activity of the knee joint.Results:All 100 patients with ACL tibial avulsion fractures successfully completed surgery.At the last follow-up,the Lachman test and anterior drawer test were negative,and the Lysholm scores,IKDC scores,and Tegner scores were significantly higher than before surgery(P<0.001).The knee joint range of motion was significantly improved compared to before surgery(P<0.001).The X-ray film showed that all fractures in 100 patients achieved anatomical or near anatomical reduction and bone healing.Conclusion:The surgical effect of arthroscopic Pushlock anchor combined with double bundle high-strength suture reconstruction for ACL tibial insertion avulsion fracture is clear,the results are satisfactory,and it is worth promoting.